The prevalence of metabolic syndrome (MS) in HIV-infected patients on highly active antiretroviral therapy (HAART) is a subject of debate. We investigated the prevalence of MS in a cohort of Danish HIV-infected patients and estimated the effect of the various classes of antiretroviral therapies on the prevalence of MS and its components. MethodsA cross-sectional study was performed in which data were obtained from fasting blood tests, anthropometry, an interview questionnaire and whole-body dual-energy X-ray absorptiometry (DEXA) scans. MS was defined using the National Cholesterol Education Programme (NCEP) Adult Treatment Panel (ATP) III diagnostic criteria. ResultsFive hundred and sixty-six patients were included in the study, of whom 27% were diagnosed with MS. In univariate analysis, the duration of treatment with different drug classes was associated with the prevalence of MS. In multivariate analysis, no association was demonstrated between therapeutic duration or modality and the occurrence of MS. Current nonthymidine reverse transcriptase inhibitor (NRTI) and protease inhibitor (PI) therapies were both associated with increased plasma triglycerides (TG) [odds ratio (OR) 3.42, 95% confidence interval (CI) 1. and OR 1.96, respectively]. ConclusionsMS is prevalent in HIV-infected Danes. However, treatment with specific drug classes does not seem to confer an elevated risk for MS, other than the risk conferred by known acute effects on triglycerides.Keywords: highly active antiretroviral therapy, HIV-associated lipodystrophy syndrome, HIV infection, metabolic syndrome IntroductionThe concept of metabolic syndrome (MS), which specifies a cluster of interrelated risk factors for cardiovascular disease, was reintroduced by Reaven in 1988 [1]. Predictors for the development of MS include excess weight, physical inactivity and aging, and the syndrome is closely associated with insulin resistance. Since its identification, the epidemiology and consequences of the syndrome have been studied intensively.In HIV-infected patients, the prevalence of MS has been reported to be 16-24% [2][3][4][5][6][7][8][9]. However, selection bias and small study populations have hampered these prevalence studies. The influence of highly active antiretroviral therapy (HAART) on the development of MS is still a matter of controversy, but a higher prevalence of MS in HIV-infected patients on HAART compared with the background population has been proposed [7,9]. An Correspondence: Dr Birgitte R. Hansen, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, DK-2650 Hvidovre, Denmark. Tel: 1 4536322108; fax: 1 4536323797; e-mail: brhansen@dadlnet.dk DOI: 10.1111/j.1468-1293.2009.00697.x HIV Medicine (2009 r 2009 British HIV Association 378 increased prevalence of MS has also been demonstrated among patients currently or previously treated with protease inhibitors (PIs) [2,5,8,10]. Multiple studies have documented metabolic and morphological complications in HIV-infected patients on HAART. Antiretrovir...

This method provides estimates for the proportion of treated patients in a cohort who harbour resistance on a given date, which are less likely to be affected by selection bias due to missing resistance data and will allow us to estimate prevalence of resistance to different drug classes at specific timepoints in HIV-infected populations on ART.